CNIs: immediate benefits but storing problems for the future?
The barriers to the success of early patient and graft survival after liver transplantation have been progressively resolved. Now, strategies to provide this life-saving technique in quality-oriented and cost-effective manner in the long term are emerging as the next central issues. Beyond the first year of transplant, the risk of surgical complications and infection is reduced, and the incidence of rejection falls precipitously. Instead, attention is turning to minimization of recurrence of original diseases including malignancy and de novo diseases. Attempt to minimize toxicity of immunosuppressive agents and their potential negative impact on metabolic and renal function is another central issue. This is important especially in pediatric patients who are expected to survive at least more than decades after transplantation.
Kiuchi
Tetsuya
T
Division of Transplantation Surgery, Department of Surgery, Nagoya University Hospital, Nagoya University Graduate School of Medicine, Tsurumai-cho, Showa-ku, Nagoya, Japan. kiuchi@med.nagoya-u.ac.jp
D000367:Age Factors; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D006084:Graft Rejection / Q000378:metabolism / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis; D007677:Kidney Function Tests; D016031:Liver Transplantation / Q000009:adverse effects*; D055502:Secondary Prevention; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus